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Authorities say people have expressed frustration about rescuing addicts who often immediately resume using the potentially deadly drug. There are also concerns voiced about the wide-ranging social and government budget costs involved, including for the overdose antidote naloxone.

Some signs of heroin overdose backlash:

- Gov. Paul LePage in hard-hit Maine vetoed legislation this year to expand access to naloxone, usually under the brand name Narcan. He has explained that when people are receiving a dozen or more doses, they should start having to pay for it. The Legislature overrode his veto.

- An effort by authorities in Ohio's Hamilton County to get a dangerous heroin batch off the streets by offering immunity for people who turn in drugs drew a rebuke from Sheriff Richard Jones in neighboring Butler County, who argued it only enables dealers and users and gives them an excuse if they are caught.

- A police photo of a grandmother and her boyfriend unconscious after overdosing with a 4-year-old boy in their car went viral this month after the police department in Ohio's East Liverpool posted it on Facebook, drawing thousands of comments including from people decrying lenience toward users who endanger children or steal to support their habits.

- A retired attorney wrote an op-ed column in The Cincinnati Enquirer examining the costs of treating heroin addiction, the strain on public resources and the rise in "drugged driving" accidents as he urged aggressive punishment. "What social policy is advanced by subsidizing recklessness?" John M. Kunst Jr., of suburban Cincinnati, wrote earlier this year. "Why do we excuse and enable addiction?"

"I understand the frustration," said Police Chief Thomas Synan Jr. of Newtown, Ohio, who heads a Cincinnati-area heroin coalition task force. "I understand the feeling that someone is doing something to themselves, so why do the rest of us have to pay? But our job is to save lives, period."

He started hearing more of the frustration amid an overdose spike in the Cincinnati area that saw 174 reported overdoses within six days last month. And the outbreaks continue, with seven overdose deaths Saturday in the Cleveland area.

Synan said unlike with repeat heroin overdosers, he has never had members of the public say he shouldn't try to save a habitual drunk driver after an auto accident or someone who has repeatedly attempted suicide.

Marion, Ohio, Fire Capt. Wade Ralph said heroin has an "extremely expensive" toll on his department, struggling to keep up while being understaffed and relying on donations from health organizations for naloxone to revive those who overdose.

"There's a human factor to that that some people, I think, just forget about or maybe they ignore it and say, 'Hey screw it, let them die.' I'm like, you can't do that. We have people here, we have guys at the firehouse, whose kids have been hooked on stuff like that," said Ralph, whose city of some 37,000 people was hit last year by 30 overdose hospitalizations and two deaths in a 12-day stretch.

In the Cincinnati area, first responders have held the death toll to what appears to be low double digits, pending lab results. The spreading practice of mixing heroin with the powerful painkiller fentanyl or with carfentanil, so strong it's used to tranquilize elephants, has resulted in frequent needs for multiple doses of naloxone.

"If they weren't doing their job, they'd all be dead," said Christel Brooks, a recovering addict in Cincinnati who said she's been clean for 12 years now. She said the problem is lack of treatment facilities and other resources for intervention before rescued addicts resume drug use.

Wilkes-Barre, Pennsylvania, Fire Chief Jay Delaney wrote this year to federal and state lawmakers for funding for the naloxone, expecting to administer doses this year worth about $10,000 to $11,000 at $40 each.

"Whether a firefighter is saving one from a burning building or administering Narcan, you're still saving that human being's life, so that's a big deal to us," said Delaney, whose department has received grant money this year but needs a steady funding answer. "We never thought ... that we would have so many that we would have to deal with so it became a funding crisis."

Lawrence, Massachusetts, police last week released cellphone video of an overdosed mother lying in a store aisle while her toddler daughter tried to revive her before paramedics arrived and did so.

Family Dollar clerk Nicaurys Anziani, who called 911, told The Eagle-Tribune newspaper she felt terrible for the little girl, who "was just crying and crying and crying."

Police said they hoped sharing the video will alert people to the consequences of drug use that they see on the front lines, as East Liverpool police explained about their photo of the overdosed couple with a child.

Ron Calhoun, an anti-drug activist in northern Kentucky, disputes suggestions he hears often that reviving people with naloxone is enabling heroin use.

"The only thing Narcan enables is breathing," he responds. "We just want to keep them alive and get them into treatment."

He said one young woman he knows had been revived 15 times with naloxone.

"And today, she's in rehab," Calhoun said. "Corpses don't do well in rehab."

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Contributing to this report were Associated Press writer Kantele Franko in Columbus, AP photographer John Minchillo in Cincinnati, and AP researcher Jennifer Farrar in New York.